Thursday, November 30, 2006

Although newFNP has been in practice over a year, she is still surprised by the amount of firsts she has.

For instance, yesterday she was asked by a patient - in the hallway after the visit had ended - to write a letter on her behalf allowing her to bring her own linens to the conjugal visits with her incarcerated husband. Although she may have sensitive skin, newFNP's patient is clearly not a modest woman.

So let newFNP think. Hmm.... medical issue? She doesn't even have atopic dermatitis! Possible smuggling consequences? NewFNP is almost 100% sure that her malpractice insurance does not cover "prison break."

While considering her request, newFNP has tried to envision the sheets provided by the penal system for such purposes. Her hunch is that they are more 'army surplus blanket' than '600-thread count sateen'. All creature (dis)comforts aside, newFNP thinks that she will decline to write this utterly non-medical letter. Sadly, newFNP's patient will have to endure the prison-issue sheets and newFNP will have to deal with the resulting fungal, bacterial or viral consequences as they come.

Tuesday, November 14, 2006

One reason is that, for some reason, patients do not hesitate to call at 10:00 PM to cancel their dental appointment for the following day. After a glass of wine, newFNP could not give a shit whether or not you cancel your appointment and she most certainly does not want her private evening time disturbed by this mundane request. She also wonders who in the hell thinks to call the after-hours phone to cancel their appointment! NewFNP knows that many of her patients are not savvy and wishes that she was allowed to simply hang up on them. Alas, there is a record of who is on call and newFNP is still interested in maintaining her employment.

Secondly, newFNP has to cart the stupid call phone everywhere she goes, including the gym, dinners out, H&M, JCrew, etc. What the hell. Please, leave newFNP to her elliptical machine, hamachi carpaccio, $12 t-shirts and $150 cashmere v-necks in peace. NewFNP had 19 calls yesterday. Nineteen. One was for a medical reason. Eighteen were front office issues.

Finally, in newFNP's clinic, clinicians are not compensated for their on call time. If newFNP were compensated $5 per on-call day, she would have 3 new cashmere sweaters per annum. Now that would make the call experience much more worth it.

Wednesday, November 08, 2006

NewFNP apologizes for the recent silence, but she has moved (homes, not clinics) and is just settling in to her new place. Ahhhh.... home sweet apartment home.

Anyway.

NewFNP must have previously noted how patients' chief complaints come in waves. One day it's nothing but pap smears - one vag after another. The only difference is the amount of hair. You might be surprised to know that a 250-pound woman has the flexibility to get a Brazilian but they do! The next day, one might be swimming in abscesses and chalazions. Frankly, it's uncanny - do newFNP's patients all know each other and coordinate their visits? Perhaps they figure that newFNP will really be on her game if they all come for the same thing on the same day. Suckers!

So newFNP just had the diabetes and depression day. Some patients even had both. Now, newFNP is no expert on either, but can manage each effectively in the primary care setting. NewFNP admits that she is a little dodgy when it comes to changing for oral hypoglycemics to insulin, but she has no fear regarding starting an adult patient with depression on an SSRI. But one after the frigging other for eight hours? Fucking hell. NewFNP thinks of her mental health colleagues and is so thankful that there are people in this world who can address these sometimes debilitating depression cases. Because newFNP sure as hell cannot during her 15 minutes. The diabetes/depression day is not a rewarding one for newFNP. It just doesn't make for a fun clinic day.

That is until newFNP was rewarded for her diabetes/depression diligence with The Third D: Dookie. Now, newFNP is no stranger to euphemisms for the act of moving one's bowels. She generally, however, reserves 'dookie' for elementary school students and not for 38-year old men. NewFNP truly attempts to be professional during her visits with patients, but then someone says something like this, "Yeah, I used to dookie like 3 or 4 times a day, but now I maybe dook once. Maybe twice, but I used to dookie a lot." All that newFNP heard was "dookie, dook, dook, dookie, dook." Oh, it was awesome. NewFNP was biting the inside of her lip in order not to start laughing.

Wednesday, November 01, 2006

No, newFNP is not speaking of the large anal warts she saw, nor of the 29-pound 13 month old whose parents state that they give her about 80 ounces of whole milk per day, in addition to both chocolate milk, juice and the occasional soda.

Nope, newFNP's clinic had a visit from our state's democratic gubernatorial candidate. In what newFNP considers a 'preaching to the choir' get out the vote effort, Mr. Candidate did a little walk through, hand-shaking, baby-kissing visit complete with secret service and television cameras. NewFNP has already voted for this underdog thanks to the ole absentee ballot, but she was glad to see him seeing a side of our city that many politicians would love to - and largely do - ignore.

Thank goodness newFNP was still rocking the sleek blowout from her star hairdresser and was wearing a smart outfit today!

This blog is for new NPs or NP students who want some real 411 on the life of a new practitioner. A new practitioner in a busy, understaffed, urban community health clinic in a major metropolitan area. Oh, and newFNP swears while writing and, sometimes, while working although she tries to keep those swears to herself. Consider yourself warned.